ABSTRACT
PURPOSE: Many techniques have been described to correct anterior hypospadias with variable results. Anterior urethral advancement as one stage technique was first described by Ti Chang Shing in 1984. It was also used for the repair of strictures and urethrocutaneous fistulae involving distal urethra. We report our experience of using this technique with some modification for the repair of anterior hypospadias. MATERIALS AND METHODS: In the period between 2013-2015, 20 cases with anterior hypospadias including 2 cases of glanular, 3 cases of coronal, 12 cases of subcoronal and 3 cases of distal penile hypospadias were treated with anterior urethral advancement technique. Patients' age groups ranged from 18 months to 10 years. Postoperatively, patients were passing urine from tip of neomeatus with satisfactory stream during follow up period of 6 months to 2 years. RESULTS: There were no major complications in any of our patients except in one patient who developed meatal stenosis which was treated by periodic dilatation. Three fold urethral mobilization was sufficient in all cases. CONCLUSION: Anterior urethral advancement technique is a single-stage procedure with good cosmetic results and least complications for anterior hypospadias repair in properly selected cases.
Subject(s)
Hypospadias/surgery , Urethra/surgery , Urologic Surgical Procedures, Male/methods , Child , Child, Preschool , Humans , Infant , Male , Treatment OutcomeABSTRACT
OBJECTIVE: Urethrocutaneous fistula, which occurs after hypospadias surgery, is often a baffling problem and its treatment is challenging. The study aimed to evaluate the results of the simple procedure (Durham Smith vest-over-pant technique) for this complex problem (post-hypospadias repair fistula). METHODS: During the period from 2011 to 2015, 20 patients with post-hypospadias repair fistulas underwent Durham Smith repair. Common age group was between 5 and 12 years. Site wise distribution of fistula was coronal 2 (10%), distal penile 7 (35%), mid-penile 7 (35%), and proximal-penile 4 (20%). Out of 20 patients, 15 had fistula of size <5 mm (75%) and 5 patients had fistula of size >5 mm (25%). All cases were repaired with Durham Smith vest-over-pant technique by a single surgeon. In case of multiple fistulas adjacent to each other, all fistulas were joined to form single fistula and repaired. RESULTS: We have successfully repaired all post-hypospadias surgery urethrocutaneous fistulas using the technique described by Durham Smith with 100% success rate. CONCLUSION: Durham Smith vest-over-pant technique is a simple solution for a complex problem (post hypospadias surgery penile fistulas) in properly selected patients.
Subject(s)
Cutaneous Fistula/surgery , Hypospadias/surgery , Penis/surgery , Surgical Flaps , Suture Techniques , Urethral Diseases/surgery , Urinary Fistula/surgery , Urologic Surgical Procedures, Male/adverse effects , Child , Child, Preschool , Cutaneous Fistula/diagnosis , Cutaneous Fistula/etiology , Humans , Hypospadias/diagnosis , Male , Patient Selection , Postoperative Complications/etiology , Surgical Flaps/adverse effects , Suture Techniques/adverse effects , Treatment Outcome , Urethral Diseases/diagnosis , Urethral Diseases/etiology , Urinary Fistula/diagnosis , Urinary Fistula/etiologyABSTRACT
Ureterocalycostomy can be performed in patients in whom desired methods of treating secondary PUJ (Pelvi-Ureteric Junction) obstructions either failed or could not be used. In our study, one child and two adults in whom one redo-ureterocalycostomy and two ureterocalycostomies were performed for severely scarred PUJ. The causes for secondary PUJ obstruction were post-pyelolithotomy in one case, post-pyeloplasty and ureterocalycostomy for PUJ obstruction in the second patient and the third patient had long upper ureteric stricture post-ureteropyeloplasty due to tuberculosis. In all these cases ureterocalycostomy proved to be salvage/final resort for preserving functional renal unit.
Subject(s)
Hydronephrosis/congenital , Kidney Calices/surgery , Multicystic Dysplastic Kidney/surgery , Ureter/surgery , Ureteral Obstruction/surgery , Ureterostomy/methods , Adult , Child, Preschool , Female , Follow-Up Studies , Humans , Hydronephrosis/surgery , Male , Reproducibility of Results , Treatment Outcome , Young AdultABSTRACT
ABSTRACT: Ureterocalycostomy can be performed in patients in whom desired methods of treating secondary PUJ (Pelvi-Ureteric Junction) obstructions either failed or could not be used. In our study, one child and two adults in whom one redo-ureterocalycostomy and two ureterocalycostomies were performed for severely scarred PUJ. The causes for secondary PUJ obstruction were post-pyelolithotomy in one case, post-pyeloplasty and ureterocalycostomy for PUJ obstruction in the second patient and the third patient had long upper ureteric stricture post-ureteropyeloplasty due to tuberculosis. In all these cases ureterocalycostomy proved to be salvage/final resort for preserving functional renal unit
